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应用伊朗人乳头瘤病毒疫苗成本效益研究的简单模型

Applying a Simple Model of Cost Effectiveness Study of HPV Vaccine for Iran.

作者信息

Khatibi Mohsen, Rasekh Hamid Reza

机构信息

Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Pharm Res. 2015 Spring;14(2):635-49.

Abstract

HPV vaccine has been recently added to the Iran Drug List, so decision makers need information beyond that available from RCTs to recommend funding for this vaccination. Modeling and economic studies have addressed some of those information needs. We reviewed cost effectiveness studies to find a suitable model for Iranian population to determine the potential cost effectiveness of HPV vaccine program based on domestic available epidemiologic data. Articles were obtained from an extensive literature search to determine the cost effectiveness of implementing an HPV vaccination program with routine cervical cancer screening. A total of 64 studies were included in this review. Although the studies used different model structures, baseline parameters and assumptions (either a Markov, Hybrid, or Dynamic model). Most of the proposed cost effectiveness models need to model the probability of HPV acquisition, the possible progression from HPV infection to CIN I, CIN II, CIN III and cervical cancer, the probability of HPV transmission which are not available in Iranian epidemiologic data. Based on the available epidemiologic data in Iran, the simplified and it requires substantially fewer assumptions than the other more complex Markov and hybrid models, therefore we decided to use this model for the evaluation of cost effectiveness of HPV vaccine in Iran.

摘要

人乳头瘤病毒(HPV)疫苗最近已被列入伊朗药品清单,因此决策者需要随机对照试验(RCT)之外的信息,以便为该疫苗接种提供资金建议。建模和经济研究已满足了其中一些信息需求。我们回顾了成本效益研究,以找到一个适用于伊朗人群的模型,从而根据国内现有的流行病学数据确定HPV疫苗接种计划的潜在成本效益。通过广泛的文献检索获取文章,以确定实施HPV疫苗接种计划并进行常规宫颈癌筛查的成本效益。本综述共纳入64项研究。尽管这些研究使用了不同的模型结构、基线参数和假设(马尔可夫模型、混合模型或动态模型)。大多数提出的成本效益模型需要对HPV感染概率、HPV感染向CIN I、CIN II、CIN III和宫颈癌的可能进展、HPV传播概率进行建模,而这些在伊朗流行病学数据中并不存在。基于伊朗现有的流行病学数据,该模型较为简化,与其他更复杂的马尔可夫模型和混合模型相比,所需假设大幅减少,因此我们决定使用该模型评估伊朗HPV疫苗的成本效益。

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